Diagnostic accuracy of N‐terminal pro‐brain natriuretic peptide for Kawasaki disease: An updated systematic review and meta‐analysis

Objective This study aimed to investigate the diagnostic accuracy of circulating N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) for Kawasaki disease (KD). Methods We searched the PubMed, Web of Science and EMBASE databases to identify the eligible studies investigating the diagnostic accuracy of NT‐proBNP for KD. The revised tool for the quality assessment of diagnostic accuracy studies (QUADAS‐2) was used to evaluate the eligible studies' quality. A meta‐analysis was performed with the bivariate model and summary receiver operating characteristic (sROC) curve. We also performed subgroup, publication bias and sensitivity analyses. Results We included 12 studies with 2173 KDs and 1909 control. The pooled sensitivity and specificity of eligible studies were 0.80 (95%CI: 0.72‐0.86) and 0.81 (95%CI: 0.73‐0.88), respectively. The area under sROC curve was 0.88 (95%CI: 0.84‐0.90). Patient selection bias and partial verification bias were the major design weakness of the eligible studies. Sensitivity analysis revealed that the results of this meta‐analysis were robust. Subgroup analysis revealed that study design, NT‐proBNP assay and participants' body temperature were not the source of heterogeneity across all eligible studies. No publication bias was observed. Conclusion NT‐proBNP has moderate diagnostic accuracy for KD. It cannot be used for ruling in or ruling out KD when used alone.